Surviving shift work

ISNA Bulletin, Feb-April, 2008 by Diane E. Scott

The National Sleep Foundation (2007) states that people who work night shift tend to be most fatigued at 4 AM, so try not to plan the most monotonous tasks during that time.

The following tips can be done to encourage alertness during night shift:

* Schedule short breaks as often as possible throughout the shift.

* Exercise when feeling fatigue, such as climbing a set of stairs or taking a walk to the cafeteria.

* Avoid unhealthy foods during the shift.

* Develop a system to monitor the fatigue levels among the members of the team.

* Never rely on dangerous medications to enhance alertness.

* Develop a partner system that serves as a check and balance when completing tasks during periods of fatigue.

The Drive Home

The dangers of driving under the influence of alcohol is well known throughout the world, however, driving after shift work can be extremely dangerous as well. A 2006 Institute of Medicine report on Sleep Disorders and Deprivation stated that almost 20 percent of all serious car crash injuries in the general population are associated with driver sleepiness, independent of alcohol effects. Many nurses will open the car windows and turn the volume of the radio up to combat fatigue, but, according to the NSF, studies have proven that these methods do not work. In fact, these actions should signal that one is dangerously fatigued and needs to pull over immediately.

The NSF has offered the following recommendations for driving after shift work:

* Carpool when possible and keep a dialogue with the person who is driving.

* Take public transportation when possible.

* Drive defensively

* Don't stop for a night cap.

Ignoring fatigue signs can be dangerous. Taking deliberate steps to understand and control the bodies natural rhythms is essential to the health and wellbeing of nurses and the patients in their care.

References

Akerstedt, T. (2005) Shift work and sleep disorders. Sleep, 28, 9-11.

Berger, A. M. & Hobbs, B. (2006). Impact of shift work on the health and safety of nurses and patients. Clinical Journal of Oncology Nursing, 10 (4), 465-471.

Folkard, S., Lombardi, D. A., & Tucker, P.T. (2005). Shiftwork: Safety, sleepiness and sleep. Industrial Health, 43, 20-23.

Hughes, R., & Stone, P. (2004). The perils of shift work: Evening shift, night shift, and rotating shifts: Are they for you? American Journal of Nursing, 104(9), 60-63.

Institute of Medicine. (2006) Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: National Academies Press.

The National Sleep Foundation (2007). Shift work. Retrieved September 11, 2007 from www. sleepfoundation.org

by Diane E. Scott, RN, MSN

Reprinted with permission from the Center for American Nurses